Hello, buncey.

I'm sorry you're continuing to have problems with your knee. Generally, per published rehab protcols, it would be expected for a person to have full extension at this point post op. How far off is your extension (straightening)? Are you able to contract your quad muscles at all? Can you tell us a little about what you are doing for physical therapy to help regain range of motion? 

Many of us with arthrofibrosis have found that our doctors and physical therapists know very little about properly treating the condition. It's really important that you educate yourself on the subject. Here are some links to info on KNEEguru's main website:

Dr. Noyes’ arthrofibrosis course and Dirk_PT’s rehab course

http://www.kneeguru.co.uk/KNEEtutor/doku.php

Dr. Millett article

http://www.casebook.kneeguru.co.uk/index.php/knee/issues/arthrofibrosis_of_the_knee/

KneeGuru literature review (look under problems with healing)

http://www.kneeguru.co.uk/insights/doku.php

Also, you can learn a lot by reading through some of the old threads archived this board. There's a wealth of information here.

Best wishes,

Jaci

Hi buncey,

That sounds like a pretty significant loss of extension from your description. At one point I had 38 degrees extension; I could stack my fists on top of each other, place them under my knee, and still have space left. I would do prone hangs-- where you lie on your stomach on the bed with legs hanging off the edge of the bed. Legs are positioned so the bed hits just above kneecap. I had to place a rolled up towel just above my knne for a little padding. If your affected knee gets too sore, use your other leg to bend it up a little to relieve it.

I'm glad you are still using crutches because you can cause stress to your knee joint, hips, back, and feet if you try to get around with that much loss of motion. Even though you're on crutches, it's important to try to maintain as normal a gait as possible. Think heel to toe, heel to toe, when you are walking (crutching) and do your best to walk that way. It sounds like the tissues in the bottom of your foot may be tightening up. Rolling your foot around on a tennis ball or other small ball while seated will help to loosen the tissues. Also, you can try massaging and stretching your calf and leg. I found that taking potassium helped a lot with cramping when I had swelling. From what I can figure, the swelling threw off the electrolytes in my body and contributed to severe foot and calf cramps. I took potassium tablets, but you can also just try eating a couple bananas everyday.

Here's a link to a really good ACL recon rehab protocol. It will give you some ideas about range of motion (ROM) goals for a normal acl recon recovery. It does have some good instructions on things that you can do at this point, such as lying wallslides, passive extension, quad sets. Because of your motion loss, you should not try to do the more advanced exercises.

http://www.drmillett.com/pdf/acl.pdf

More than one session of formal PT a week would probably be a good idea, but only if it's the proper PT. Some PT believe that arthrofibrosis should be treated with forceful bending and straigthening. That's the exact opposite of what should be done. Forceful PT leads to more swelling and inflammation and may lead to more scar tissue formation. If your knee is reacting badly to hourly PT at home you may need to tweak your PT a bit. Maybe do extension during one session and flexion in another. Maybe try less reps or less time. Or, wait a little longer between sessions. Are you icing and elevating immediately after your exercises? It's extremely important to get the swelling under control because it can lead to more scar tissue formation.

Good luck with your research.

Jaci

PS-- I'm going to send you a personal message. To chcek your mailbox, look in the user info box near the upper left-hand corner of the webpage. It says "Hey, buncey, you have _____ messages, x are new." Just click on the underlined number of messages.